Northway, Roger Patrick
Northway, Roger Patrick is an individual health care provider with primary practice located at 13105 W Bluemound Rd Suite 100, Brookfield WI 53005-8046. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Northway, Roger Patrick can be contacted via phone (262) 641-9790.Contact Information
Primary practice address
13105 W Bluemound Rd Suite 100
Brookfield WI 53005-8046
Phone: (262) 641-9790
Fax: (262) 641-9791
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Professional | 101YP2500X | 477125 | Wisconsin |
Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 2661123 | Wisconsin |
Profile Details
NPI number | 1053449173 |
---|---|
LBN Legal business name | Northway, Roger Patrick |
Credentials | MS LCSW |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Mar 1st, 2007 |
Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1053449173 | NPPES |
Wisconsin | MEDICAID | 39197200 |
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